can someone tell me if an auto cpap comes to me with a pressure range of 4 -20cm why it should be set at about three below and three higher than the pressure reading of my sleep study.........and if i have to wait for an appointment is the 4-20 range oe.ka. for now? ............seems i stay confused, i thought automatic meant automatic.....silly me..........thanks
auto cpap ?
9 posts
• Page 1 of 1
-
whatrdreamsmadeof
- Posts: 421
- Joined: Sat Aug 19, 2006 2:12 pm
- Location: vA. BEACH, VA.
-
DreamStalker
- Posts: 7509
- Joined: Mon Aug 07, 2006 9:58 am
- Location: Nowhere & Everywhere At Once
Your pressure is likely set incorrectly as the range of 4 to 20 is way too large. Did you have a sleep study done? ... If yes, were you titrated or given a prescription for a specific pressure? or pressure range?
Automatic means that the CPAP runs at the low end of your range and adjusts the pressure higher if it senses restricted flow.
We need more info to help you out ...
- roberto
Automatic means that the CPAP runs at the low end of your range and adjusts the pressure higher if it senses restricted flow.
We need more info to help you out ...
- roberto
President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.
-
whatrdreamsmadeof
- Posts: 421
- Joined: Sat Aug 19, 2006 2:12 pm
- Location: vA. BEACH, VA.
auto cpap /
Yes my titrated pressure was 9 but when i picked kup my auto they never touched it my dme is a real pain in the never mind the resmed elite i had was set at 9 but the dme was so mad she had to switch it to the vantage she just gave it to me ..........refusing to even switch out the mask is it o.k to use it with a 4-20 range for a few months?
-
DreamStalker
- Posts: 7509
- Joined: Mon Aug 07, 2006 9:58 am
- Location: Nowhere & Everywhere At Once
Re: auto cpap /
I don't think so. Use that PDF manual to help you set the minimum to about 7 and the maximum to about 12. These numbers are based on the fact that I was titrated for 10 cm and my auto was set for 8 to 13 and I am doing fine.whatrdreamsmadeof wrote:Yes my titrated pressure was 9 but when i picked kup my auto they never touched it my dme is a real pain in the never mind the resmed elite i had was set at 9 but the dme was so mad she had to switch it to the vantage she just gave it to me ..........refusing to even switch out the mask is it o.k to use it with a 4-20 range for a few months?
Having said this you may end up refining the range but you will need to start collecting data first.
Hopefully Chuck, Snoredog, or Someone else with lots of experience will chime in here and provide you with detailed advice.
EDIT: Also forgot to mention -- Call your sleep doctor and tell him/her what your DME has done (or didn't do) and advise them not to send anymore patients to that DME. Then call your insurance and tell them your story too ... hopefully you will get some respect and the service and care you deserve ... and don't roll your eyes when you tell them ... take control of your treatment ... this is serious stuff.
- roberto
Last edited by DreamStalker on Wed Aug 30, 2006 8:46 pm, edited 1 time in total.
President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.
Hello,
Your question is logical and I had the same question myself: if these are auto machines, why even bother with titration? I am not an expert, but here are some answers I have seen.
My wife has trouble breathing IN at 6 (which is where it is currently set to start out, when "ramping"), at least at the start of the evening, before her breathing has slowed down. So, a setting of 4 would not work at all for her.
Although many appreciate a lower pressure when such is workable, some report doing BETTER when the minimum pressure is not set too low. That is one reason why you don't see the pressures set "wide open", like 2-25.
One reason some don't set "wide open" at the top is a concern for "runaway" pressure increases by the machine. I have not read reports of this actually occuring, but that does not mean it has not happened -- I just started reading the posts a month ago.
Another reason I have seen people mention for a narrower pressure range is to avoid getting woken up or otherwise disturbed by a wider pressure variation during the night.
Re your wack DME, you might want to do what many here have done: get a reader and software and set your machine yourself.
It is certainly true that learning about and taking responsibity for your own situation, rather than leaving it to "who knows who," not only avoids the risks of entrusting yourself to others, it is liberating to take charge of your own condition, rather than being some "patient", dependent on God-like docs and DMEs, who, unfortunately, may sometimes have feet of clay.
I think a common feeling on this site is that our bodies are our ships and it goes a lot better if we say that we are the captains.
Best,
David
Your question is logical and I had the same question myself: if these are auto machines, why even bother with titration? I am not an expert, but here are some answers I have seen.
My wife has trouble breathing IN at 6 (which is where it is currently set to start out, when "ramping"), at least at the start of the evening, before her breathing has slowed down. So, a setting of 4 would not work at all for her.
Although many appreciate a lower pressure when such is workable, some report doing BETTER when the minimum pressure is not set too low. That is one reason why you don't see the pressures set "wide open", like 2-25.
One reason some don't set "wide open" at the top is a concern for "runaway" pressure increases by the machine. I have not read reports of this actually occuring, but that does not mean it has not happened -- I just started reading the posts a month ago.
Another reason I have seen people mention for a narrower pressure range is to avoid getting woken up or otherwise disturbed by a wider pressure variation during the night.
Re your wack DME, you might want to do what many here have done: get a reader and software and set your machine yourself.
It is certainly true that learning about and taking responsibity for your own situation, rather than leaving it to "who knows who," not only avoids the risks of entrusting yourself to others, it is liberating to take charge of your own condition, rather than being some "patient", dependent on God-like docs and DMEs, who, unfortunately, may sometimes have feet of clay.
I think a common feeling on this site is that our bodies are our ships and it goes a lot better if we say that we are the captains.
Best,
David
-
DreamStalker
- Posts: 7509
- Joined: Mon Aug 07, 2006 9:58 am
- Location: Nowhere & Everywhere At Once
You don't need the card reader and software to change settings on your machine ... but it is indeed advised if you can afford it in order to get detailed data and understand what is going on during the night.droyal wrote:Re your wack DME, you might want to do what many here have done: get a reader and software and set your machine yourself.
- roberto
President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.
APAP Min and Max pressure is 4 cm to 20 cm.droyal wrote: That is one reason why you don't see the pressures set "wide open", like 2-25.
Bi-PAP Can go to a high pressure of 25 cm to 30 cm depending on model.
Otherwise you are on the money 4 to 20 is the DME failure setting, so he can resell the machine at Auction. The inlt reason to use that setting is if you never had a study and wasn't sure if you had apnea, and even then the settings wouldn't be correct for a self test. Jim
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
there is NO set rule/range established below/above your titrated cpap pressure, certainly not 3cm.
Common sense and a understanding of how the machine works has more to do with it than anything. You have 2 pressures the autopap works with, the Min. (minimum floor pressure) and Max. (maximum ceiling). Your PSG found titrated cpap pressure of 9cm should fall within any range set.
Why you don't want to leave a new autopap set to default 4cm (Min.) to 20cm (Max.):
Minimum pressure: Default=4cm. While you can leave it there and not cause any harm, most patients find that pressure is simply too low to breathe at normally. If the Min. pressure is too low the incoming air will feel humid and stuffy and even claustrophobic. The mask and hose may also fog up more rapidly.
The Min. pressure should be set where it is comfortable for you to breathe. Most people have no problems tolerating pressure at 5cm, 6cm or even higher. This eliminates the starving for air as you are trying to fall asleep. If you are new at cpap, suggest starting at 5cm or 6cm.
Maximum pressure: Default=20cm, unless your pressure is 19cm or 20cm you should never leave it set at 20cm or wide open. The reason is runaway pressure which increases the risk of pressure induced central apnea. If the machine misreads your events it can increase pressure, if there is no limit it can go on up to 20cm under the right conditions.
The Max. pressure should be at your last titrated pressure or only slightly higher but no more than 1 or 2cm. You should also study your last PSG and note any mention of CA or MA events (Central Apnea or Mixed Apnea). If your PSG has these items listed then you should limit the Max. pressure to the cpap found titration. This way should the machine misread your SDB events (e.g. confuse a central event for a obstructive one) it won't increase beyond the set Max. If left wide open or at 20cm, it could increase pressure up to the limit and that pressure by itself could trigger more central events.
Some patients have strange breathing patterns including chronic snorers. If the autopap relies heavily on a snore as a trigger to to increase pressure if no limits are in place it could go on up to 20cm based upon snoring alone. Pressure increases to eliminate snore are suspect in triggering central events.
If your PSG lab titrated pressure was 9cm, here is what I suggest starting with:
Min. Pressure=6cm
Max. Pressure=10cm (if NO CA's or MA's were seen on PSG, else 9cm).
if Cflex start with setting 2.
So your range would be 6-10cm. If the display pressure is always at 10cm later on you might want to try 11cm as the Max. However, if your lab PSG was done correctly, your pressure in autopap mode should land at the same 9cm as the lab found, so 10cm should work for some time.
When you first turn on the machine it should go to the Min. pressure and stay there until it sees events that require pressure increase, then it will move off that pressure and drop back to it during the night if no longer needed.
Common sense and a understanding of how the machine works has more to do with it than anything. You have 2 pressures the autopap works with, the Min. (minimum floor pressure) and Max. (maximum ceiling). Your PSG found titrated cpap pressure of 9cm should fall within any range set.
Why you don't want to leave a new autopap set to default 4cm (Min.) to 20cm (Max.):
Minimum pressure: Default=4cm. While you can leave it there and not cause any harm, most patients find that pressure is simply too low to breathe at normally. If the Min. pressure is too low the incoming air will feel humid and stuffy and even claustrophobic. The mask and hose may also fog up more rapidly.
The Min. pressure should be set where it is comfortable for you to breathe. Most people have no problems tolerating pressure at 5cm, 6cm or even higher. This eliminates the starving for air as you are trying to fall asleep. If you are new at cpap, suggest starting at 5cm or 6cm.
Maximum pressure: Default=20cm, unless your pressure is 19cm or 20cm you should never leave it set at 20cm or wide open. The reason is runaway pressure which increases the risk of pressure induced central apnea. If the machine misreads your events it can increase pressure, if there is no limit it can go on up to 20cm under the right conditions.
The Max. pressure should be at your last titrated pressure or only slightly higher but no more than 1 or 2cm. You should also study your last PSG and note any mention of CA or MA events (Central Apnea or Mixed Apnea). If your PSG has these items listed then you should limit the Max. pressure to the cpap found titration. This way should the machine misread your SDB events (e.g. confuse a central event for a obstructive one) it won't increase beyond the set Max. If left wide open or at 20cm, it could increase pressure up to the limit and that pressure by itself could trigger more central events.
Some patients have strange breathing patterns including chronic snorers. If the autopap relies heavily on a snore as a trigger to to increase pressure if no limits are in place it could go on up to 20cm based upon snoring alone. Pressure increases to eliminate snore are suspect in triggering central events.
If your PSG lab titrated pressure was 9cm, here is what I suggest starting with:
Min. Pressure=6cm
Max. Pressure=10cm (if NO CA's or MA's were seen on PSG, else 9cm).
if Cflex start with setting 2.
So your range would be 6-10cm. If the display pressure is always at 10cm later on you might want to try 11cm as the Max. However, if your lab PSG was done correctly, your pressure in autopap mode should land at the same 9cm as the lab found, so 10cm should work for some time.
When you first turn on the machine it should go to the Min. pressure and stay there until it sees events that require pressure increase, then it will move off that pressure and drop back to it during the night if no longer needed.
What did the script that your Dr wrote for the vantage specify? The difference between ordering online and a "local" DME is that the local DME is required to set the APAP at what the Dr ordered. If your DR ordered 4-20 that is what they have to go with. Also, they cannot trade out the mask if it has not been 3 months. I am not trying to stick up for your DME because I don't know the whole story or how it was handled. It is hard to judge from an internet posting how things were said. I can't speak for everyone, but I dislike working with physician orders from physicians that are not educated in Sleep apnea and CPAP. Sometimes I have to set a patient up on settings that are not what would help the patient the most. I always call and question the Dr, but sometimes they will not change the orders. In this area we have some Dr's that write a mask brand and size that we have to give the patient. I hate that. It really ties my hands as far as patient comfort.
9 posts
• Page 1 of 1